Developmental Dissonance, Why Relationship is the Most Essential Component of Treatment for Psychosis

Eric Kandel wrote that the right experience at the right time is crucial for normal psychological and neurobiological development. Similarly, trauma, both mental and physical occurring at critical stages can disrupt... [ view full abstract ]

Eric Kandel wrote that the right experience at the right time is crucial for normal psychological and neurobiological development. Similarly, trauma, both mental and physical occurring at critical stages can disrupt psychological and neurobiological development. In this paper, I present a novel model of psychosis based on developmental dissonance between neural circuits in the prefrontal cortex and those in the basal ganglia. Using working memory as a construct, I will provide an example of how early development in prefrontal regions combined with slower development in the basal ganglia create a mismatch, a development dissonance, that leads to disruption in thought processes. Adequately addressing this mismatch in development requires patience, space, and interpersonal interactions that stimulate and allow growth to occur.

Currently, individuals experiencing psychosis are treated with antipsychotics that may reduce symptoms, but limit the stimulation necessary for circuits to develop. Rather than a pharmacological intervention, individuals experiencing psychosis require relational interactions from therapists, family, friends and coworkers to address the mismatch in development and encourage growth.